AHA Rejects Proposed Readmission Penalties

Cheryl Clark, June 25, 2012

Federal officials "ignored Congress's intent" when it wrote its proposed rules governing how hospitals will be penalized up to 1% for higher readmission rates, said American Hospital Association executive vice president Rick Pollack.

That's in part because the May 11 document by the Centers for Medicare & Medicaid Services does not exclude all planned and unrelated readmissions from being counted against the 3,393 hospitals affected by the penalty rule, which will take effect Oct. 1, the AHA says.

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Additionally, the formula CMS proposes is viewed as discriminatory against hospitals with higher percentage of non-white patients, higher percentages of so-called dually-eligible patients who are covered by both Medicaid and Medicare.

And, hospitals contend, it places at a disadvantage those hospitals that receive disproportionate share funding, called DSH facilities, because they have more underinsured and uninsured patients. Pollack said that readmissions among such patient populations are "beyond (the) hospitals' control."

Pollack made his remarks to CMS last week in a 62-page letter that included objections to several other parts of the proposed Inpatient Prospective Payment System rule, for which the comment period ends Monday, June 25. 


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